River Hills Health and Rehabilitation Center
2091 Bandera Hwy, Kerrville, TX 78028
River Hills Health and Rehabilitation Center, a 150-bed for profit - individual nursing facility in Kerrville, TX, holds a 1-star CMS overall rating - below the 3.0-star national average, ranking #1,006 of 1,165 rated homes in TX on CMS overall stars (with health+staffing+quality tie-breaks), with nurse staffing below the national norm. 6 inspection findings reached the actual-harm or immediate-jeopardy level.
CMS combines health inspections, nurse-staffing levels, and clinical quality measures into the overall star rating, read the components below; they often tell a sharper story than the headline.
Phone: 8302579900
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- 1 / 5
- Much below average · CMS overall · nat'l 3.0
- #1,006 of 1,165
- In-state rank among rated TX homes
- 3.11
- Well below average · nurse hrs/day · nat'l 3.86
- 50
- Inspection findings · 6 serious
If a nursing-home resident is in immediate danger, call 911.
For elder abuse or neglect concerns, contact your state's Adult Protective Services (search "APS" + your state) or call the Eldercare Locator at 1-800-677-1116. For facility advocacy, reach your Long-Term Care Ombudsman. CMS ratings and inspection data below are a research screen, not an emergency channel.
The verdict
River Hills Health and Rehabilitation Center, a 150-bed for profit - individual nursing facility in Kerrville, TX, holds a 1-star CMS overall rating - below the 3.0-star national average, ranking #1,006 of 1,165 rated homes in TX on CMS overall stars (with health+staffing+quality tie-breaks), with nurse staffing below the national norm. 6 inspection findings reached the actual-harm or immediate-jeopardy level.
- 1 / 5
- CMS overall · national 3.0
- #1,006 of 1,165
- In-state rank among rated TX homes
- 3.11
- Nurse hrs/resident-day · national 3.86
- 50
- Inspection findings · 6 serious
CMS force-curves overall stars within each state; read health, staffing, and quality sub-ratings alongside the headline.
In-state ownership mix · peer inventory
How 1,177 TX nursing homes split by ownership sector
This facility is recorded as For profit - Individual. Sector buckets collapse CMS ownership_type into For-profit, Nonprofit, and Government, orthogonal to the RN/LPN/CNA hour bar below.
Health Inspection
Staffing
Quality Measures
Long-Stay Quality
Facility Information
- Provider Number
- 676114
- Ownership
- For profit - Individual
- Provider Type
- Medicare and Medicaid
- Beds
- 150
- Residents
- 99
- In Hospital
- No
- County
- Kerr
- Last Inspection
- Jun 13, 2025
Staffing Data
How the 3.11 total nursing hours per resident-day are staffed:
- RN Hours
- 0.23 (nat'l avg: 0.69)
- LPN Hours
- 1.04
- CNA Hours
- 1.83
- Total Nursing Hours
- 3.11 (nat'l avg: 3.86)
- PT Hours
- 0.09
- Nursing Turnover
- 75.9%
- RN Turnover
- 83.3%
What the CMS Record Reveals About River Hills Health and Rehabilitation Center
According to CMS Nursing Home Compare, River Hills Health and Rehabilitation Center ranks #1,006 of 1,165 rated nursing homes in TX on overall stars (tie-broken by health+staffing+quality, then fewer fines). River Hills Health and Rehabilitation Center operates 150 certified beds in Kerrville, TX with approximately 99 residents currently in care, and carries a CMS overall rating of 1 out of 5 stars (health inspection 1★ · staffing 1★ · quality 4★).
The inspection file contains 50 deficiency records from recent surveys, of which 6 reached the actual-harm or immediate-jeopardy threshold on the CMS scope-and-severity grid. On the enforcement side, CMS has assessed 3 penalties totaling $112K against this provider. Reported nurse staffing runs 3.11 total hours per resident day (national average 3.86); RN hours specifically are 0.23 per resident day.
Classified as "For profit - Individual" ownership and operating as a "Medicare and Medicaid" provider, River Hills Health and Rehabilitation Center falls into a category where comparative context matters. Reported nursing staff turnover at this facility is 75.9% (CMS payroll-based measure).
Why sub-scores and the CMS methodology matter
The overall score is a composite of three weighted sub-ratings published by the Centers for Medicare & Medicaid Services: health inspection results, staffing levels, and quality measures. Because CMS caps the overall score at the health-inspection tier and then adjusts up or down based on staffing and quality, the sub-scores often tell a sharper story than the headline star count alone, a 3-star facility with weak inspection history reads differently from one held back by thin staffing.
National research consistently shows that ownership structure, staffing hours, and turnover are the three operational levers that correlate most strongly with resident outcomes, ratings and fines are lagging indicators of those upstream choices. The staffing metric in particular is the one most strongly tied to resident outcomes in peer-reviewed literature.
For families evaluating this facility, the CMS record should be read alongside a site visit, direct conversation with current residents and their families, and review of the state health department's most recent inspection report, the star rating is a starting point, not a verdict. All data on this page is sourced from CMS Provider Data and the Nursing Home Compare program; always verify the same record on Medicare.gov Care Compare and with the facility or your state survey agency before making placement decisions.
Deficiency History (50 most recent)
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Category: Resident Rights Deficiencies
Corrected: Jul 7, 2026
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Category: Pharmacy Service Deficiencies
Corrected: Jun 1, 2026
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Category: Pharmacy Service Deficiencies
Corrected: Jun 1, 2026
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Category: Freedom from Abuse, Neglect, and Exploitation Deficiencies
Corrected: Jun 1, 2026
Ensure each resident receives an accurate assessment.
Category: Resident Assessment and Care Planning Deficiencies
Corrected: Feb 6, 2026
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
Category: Resident Rights Deficiencies
Corrected: Feb 6, 2026
Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.
Category: Infection Control Deficiencies
Corrected: Dec 19, 2025
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Category: Quality of Life and Care Deficiencies
Corrected: Oct 1, 2025
Provide and implement an infection prevention and control program.
Category: Infection Control Deficiencies
Corrected: Jul 11, 2025
Have a policy regarding use and storage of foods brought to residents by family and other visitors.
Category: Nutrition and Dietary Deficiencies
Corrected: Jul 11, 2025
Ensure that residents are free from significant medication errors.
Category: Pharmacy Service Deficiencies
Corrected: Jul 11, 2025
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Category: Quality of Life and Care Deficiencies
Corrected: Jul 11, 2025
Assist a resident in gaining access to vision and hearing services.
Category: Quality of Life and Care Deficiencies
Corrected: Jul 11, 2025
Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
Category: Freedom from Abuse, Neglect, and Exploitation Deficiencies
Corrected: Jul 11, 2025
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Category: Resident Rights Deficiencies
Corrected: Jul 11, 2025
Keep residents' personal and medical records private and confidential.
Category: Resident Rights Deficiencies
Corrected: Jul 11, 2025
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Category: Nutrition and Dietary Deficiencies
Corrected: Jul 11, 2025
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Category: Pharmacy Service Deficiencies
Corrected: Jul 11, 2025
Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
Category: Nursing and Physician Services Deficiencies
Corrected: Jul 11, 2025
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Category: Quality of Life and Care Deficiencies
Corrected: Jul 11, 2025
Provide care and assistance to perform activities of daily living for any resident who is unable.
Category: Quality of Life and Care Deficiencies
Corrected: Jul 11, 2025
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Category: Resident Assessment and Care Planning Deficiencies
Corrected: Jul 11, 2025
Ensure each resident receives an accurate assessment.
Category: Resident Assessment and Care Planning Deficiencies
Corrected: Jun 3, 2025
Reasonably accommodate the needs and preferences of each resident.
Category: Resident Rights Deficiencies
Corrected: Jun 3, 2025
Provide timely, quality laboratory services/tests to meet the needs of residents.
Category: Administration Deficiencies
Corrected: Feb 9, 2025
Ensure that residents are free from significant medication errors.
Category: Pharmacy Service Deficiencies
Corrected: Feb 9, 2025
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Category: Pharmacy Service Deficiencies
Corrected: Feb 9, 2025
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Category: Quality of Life and Care Deficiencies
Corrected: Feb 9, 2025
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Category: Resident Assessment and Care Planning Deficiencies
Corrected: Dec 22, 2024
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Category: Resident Assessment and Care Planning Deficiencies
Corrected: Dec 22, 2024
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Category: Resident Assessment and Care Planning Deficiencies
Corrected: Dec 22, 2024
Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
Category: Nursing and Physician Services Deficiencies
Corrected: Dec 22, 2024
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Category: Quality of Life and Care Deficiencies
Corrected: Dec 22, 2024
Employ staff that are licensed, certified, or registered in accordance with state laws.
Category: Administration Deficiencies
Corrected: Sep 30, 2024
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Category: Pharmacy Service Deficiencies
Corrected: Sep 30, 2024
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Category: Freedom from Abuse, Neglect, and Exploitation Deficiencies
Corrected: Sep 30, 2024
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Category: Freedom from Abuse, Neglect, and Exploitation Deficiencies
Corrected: Sep 30, 2024
Have a policy regarding use and storage of foods brought to residents by family and other visitors.
Category: Nutrition and Dietary Deficiencies
Corrected: May 31, 2024
Ensure medication error rates are not 5 percent or greater.
Category: Pharmacy Service Deficiencies
Corrected: May 31, 2024
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
Category: Pharmacy Service Deficiencies
Corrected: May 31, 2024
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Category: Resident Assessment and Care Planning Deficiencies
Corrected: May 31, 2024
Ensure each resident receives an accurate assessment.
Category: Resident Assessment and Care Planning Deficiencies
Corrected: May 31, 2024
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Category: Environmental Deficiencies
Corrected: May 31, 2024
Provide and implement an infection prevention and control program.
Category: Infection Control Deficiencies
Corrected: May 31, 2024
Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.
Category: Administration Deficiencies
Corrected: May 31, 2024
Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
Category: Nutrition and Dietary Deficiencies
Corrected: May 31, 2024
Keep residents' personal and medical records private and confidential.
Category: Resident Rights Deficiencies
Corrected: May 31, 2024
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Category: Nutrition and Dietary Deficiencies
Corrected: May 31, 2024
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Category: Quality of Life and Care Deficiencies
Corrected: Jan 29, 2024
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Category: Resident Rights Deficiencies
Corrected: Jan 29, 2024
Quality Measures
| Measure | Type | Score | Used in Rating |
|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased | Long Stay | 7.6% | Yes |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | Long Stay | 0.4% | Yes |
| Percentage of long-stay residents with a urinary tract infection | Long Stay | 0.3% | Yes |
| Percentage of long-stay residents experiencing one or more falls with major injury | Long Stay | 2.1% | Yes |
| Percentage of long-stay residents whose ability to walk independently worsened | Long Stay | 5.0% | Yes |
| Percentage of long-stay residents with pressure ulcers | Long Stay | 4.2% | Yes |
| Percentage of long-stay residents who received an antipsychotic medication | Long Stay | 3.8% | Yes |
| Percentage of short-stay residents who newly received an antipsychotic medication | Short Stay | 0.0% | Yes |
| Percentage of long-stay residents who lose too much weight | Long Stay | 1.6% | No |
| Percentage of long-stay residents who have depressive symptoms | Long Stay | 0.4% | No |
| Percentage of long-stay residents who were physically restrained | Long Stay | 0.0% | No |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | Long Stay | 98.2% | No |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | Long Stay | 16.9% | No |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | Long Stay | 96.9% | No |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | Long Stay | 20.3% | No |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | Short Stay | 99.2% | No |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | Short Stay | 86.3% | No |
Penalty History 3 penalties totaling $112K
| Date | Type | Amount |
|---|---|---|
| Feb 8, 2025 | Fine | $49K |
| Dec 21, 2024 | Fine | $47K |
| Jan 10, 2024 | Fine | $15K |
Nationwide facilities with similar scale or staffing
Two data-derived peer sets for River Hills Health and Rehabilitation Center, both outside TX so the neighborhoods are not the same-state geography list below.
Similar bed count
Nearest CMS certified bed counts outside TX (150 beds here).
Similar staffing hours
Nearest CMS adjusted total nurse hours per resident day outside TX (3.32 here).
Nearby Nursing Homes in TX
1,176 other nursing homes are on record in TX; 6 are shown here.
600 Maple Ave.
Burleson, TX
Accel at College Station
College Station, TX
Accel at Willow Bend
Plano, TX
Advanced Health & Rehab Center of Garland
Garland, TX
Advanced Rehabilitation & Healthcare of Burleson
Burleson, TX
Advanced Rehabilitation & Healthcare of Live Oak
Live Oak, TX
Understanding Nursing Home Data
What the CMS records show for River Hills Health and Rehabilitation Center
The health, staffing, and quality sub-ratings above often diverge from the CMS overall headline. Use those components and the inspection findings to read the full file, not the overall star alone.
- The TX registry aggregates state averages and the highest-rated homes in this cohort. View TX registry
- Peer homes near 150 beds show how CMS stars vary at a similar scale in TX. Compare a similar-size peer
- CMS publishes separate fields for inspections, nurse staffing hours, and quality measures; the guide explains how each star is computed. How CMS ratings work
CMS refreshes Nursing Home Compare quarterly (current extract: August 2026). PlainNursing describes published records; it does not establish suitability, availability, admissions, or individual outcomes.
Frequently Asked Questions
What is the overall CMS rating for River Hills Health and Rehabilitation Center?
Where does River Hills Health and Rehabilitation Center rank among nursing homes in TX?
What are the staffing levels at River Hills Health and Rehabilitation Center?
How many beds does River Hills Health and Rehabilitation Center have?
Does River Hills Health and Rehabilitation Center have any deficiencies on record?
Has River Hills Health and Rehabilitation Center received any fines or penalties?
Who owns River Hills Health and Rehabilitation Center?
When was River Hills Health and Rehabilitation Center last inspected?
What quality measures are tracked for River Hills Health and Rehabilitation Center?
Data Sources
Data source: CMS Nursing Home Compare. Ratings, staffing, deficiency, quality measure, and penalty data are from CMS Provider Data. For informational purposes only. Verify the same CCN on Medicare.gov Care Compare and with the facility or your state health department.
Read our methodology - how this data is sourced, computed, and verified.
